How To Handle Black Eschar Formation | Podiatry Today
Dr. Hadi adds that when eschar is solely caused by an area of pressure (such as a heel pressure ulcer), it is strictly due to focal pressure necrosis. She says you can often offload these areas and the eschar will slough in time, leaving behind an epithelialized region, which avoids the creation of an ulcer.
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What do you all recommend for black heels if the wound is dry and intact?
Treatment options for intact stable eschar
rovide pressure reduction (elevate calves on pillows in bed) along with topical options: wrap the heel in dry gauze ,or paint with betadine or liquid barrier film (e.g. 3M Cavilon No Sting Barrier Film or Skin Prep Smith & Nephew ). Current standard of care guidelines, recommend that stable intact (dry, adherent, intact without erythema or fluctuance) eschar on the heels should not be removed. The reason: blood flow in the tissue under the eschar is virtually non-existent, therefore the wound is susceptible to infection with limited to no ability to fight off invading bacteria. The eschar acts as a natural barrier to infection, keeping the bacteria from entering the wound. However, should the eschar become unstable (wet, draining, loose, boggy, edematous, red) the eschar should be debrided.
**In my experience, skin prep will usually clear up the "boggyness" **